Key function for obstacle crossing in hemiplegic persons with varied degrees of spasticity.
Hideaki Tanaka, Masami Yokogawa, Takao Nakagawa and 3 others
PMID 28878467WHAT IT FOUND
Stroke patients with hemiplegia who could not isolate leg movement crossed higher obstacles when trunk function was better.
Patients with more isolated leg movement crossed higher obstacles when unaffected knee strength was stronger.
Key findings
01For participants with BRS III to IV, trunk function was the factor selected in multiple regression for maximum obstacle height, with a 75.6% contribution rate.
02For participants with BRS V to VI, unaffected-side knee extension strength was the factor selected in multiple regression for maximum obstacle height, with a 21.0% contribution rate.
03The factors linked to maximum obstacle height differed by group: in BRS III to IV, one-leg standing times and trunk function showed linear relationships; in BRS V to VI, only unaffected-side knee extension strength did.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was cross-sectional, so it cannot show that improving trunk function or knee strength would increase obstacle crossing height. Only 37 participants were studied, and they were divided into severity groups, so the findings are based on small numbers. All participants could already walk independently outdoors, so the results do not apply to people with more severe walking impairment. The obstacle was a strip of paper tape indoors, and each function test was performed once, which may not reflect repeated everyday crossings. Some participants used a cane or brace, and some could walk independently but chose not to, which may affect performance.
The easy way to misread this
Do not read these associations as proof that training trunk or knee strength will improve obstacle crossing. This was cross-sectional and did not test whether improving these functions changes maximum height.